Department of Endodontics, Faculty of Dentistry, LICIFO, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica.
Dental Materials Research Laboratory, School of Dentistry, University of Costa Rica, SJO, Sabanilla, San José, 11502, Costa Rica.
Clin Oral Investig. 2022 Aug;26(8):5491-5501. doi: 10.1007/s00784-022-04516-8. Epub 2022 May 2.
To evaluate the effect of several final irrigation protocols on radicular dentin microhardness, biochemical composition, and DMP1-CT expression.
A total of 140 single-rooted human teeth were prepared with WaveOne Gold files and randomly distributed into 7 groups (n = 20) according to the final irrigation protocol: distilled water (DW); sodium hypochlorite-EDTA (NaOCl-EDTA); EDTA (EDTA); EDTA-NaOCl (EDTA-NaOCl); EDTA-chlorhexidine (EDTA-CHX); passive ultrasonic irrigation (PUI:NaOCl-EDTA); and PUI:NaOCl-EDTA-NaOCl. Dentin microhardness (n = 10) was evaluated in the root canal lumen using Vickers hardness tester. Immunohistochemical analysis (n = 5) was used to evaluate DMP1-CT expression. Dentin ultrastructure and biochemical composition were evaluated by using Raman and energy dispersive X-ray analysis (EDAX) (n = 5) with a scanning electron microscope (SEM). Analysis of variance (ANOVA) and Tukey test were performed (p˂0.05).
Raman spectra of the organic content and DMP1-CT expression were lower at the lumen canal in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl when compared to control (p < 0.05). EDAX showed reduced values for calcium and phosphorus in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl. SEM microphotography's showed completely cleaned dentin, permeable tubules, and dentin erosion, mainly when PUI was used. NaOCl-EDTA presented significantly higher microhardness values than PUI:NaOCl-EDTA-NaOCl (p < 0.05). PUI:NaOCl-EDTA-NaOCl exhibited the lowest Vickers hardness values of all groups.
The final irrigation protocols that used a final rinse with NaOCl and PUI showed a detrimental effect on radicular dentin DMP1-CT expression, biochemical composition, and microhardness.
The adequate irrigation protocol could be advantageous to preserve the radicular dentin ultrastructure, promote adequate adhesion, and sustain favorable conditions for biomineralization and regeneration.
评估几种终末冲洗方案对根管牙本质显微硬度、生物化学成分和 DMP1-CT 表达的影响。
共制备 140 颗单根人牙,用 WaveOne Gold 锉进行根管预备,并根据终末冲洗方案随机分为 7 组(n=20):蒸馏水(DW);次氯酸钠-乙二胺四乙酸(NaOCl-EDTA);乙二胺四乙酸(EDTA);EDTA-次氯酸钠(EDTA-NaOCl);EDTA-洗必泰(EDTA-CHX);被动超声冲洗(PUI:NaOCl-EDTA);和 PUI:NaOCl-EDTA-NaOCl。使用维氏硬度计评估根管腔内牙本质显微硬度(n=10)。免疫组织化学分析(n=5)用于评估 DMP1-CT 表达。使用扫描电子显微镜(SEM)和能谱分析(EDAX)评估牙本质超微结构和生物化学成分(n=5)。采用方差分析(ANOVA)和 Tukey 检验(p˂0.05)。
与对照组相比,EDTA-NaOCl、PUI:NaOCl-EDTA 和 PUI:NaOCl-EDTA-NaOCl 中的根管腔内有机含量和 DMP1-CT 表达的 Raman 光谱较低(p<0.05)。EDAX 显示 EDTA-NaOCl、PUI:NaOCl-EDTA 和 PUI:NaOCl-EDTA-NaOCl 中的钙和磷值降低。SEM 显微摄影显示,主要在使用 PUI 时,牙本质得到了彻底清洁,管腔通透,牙本质侵蚀。NaOCl-EDTA 组的显微硬度值显著高于 PUI:NaOCl-EDTA-NaOCl 组(p<0.05)。PUI:NaOCl-EDTA-NaOCl 组的维氏硬度值最低。
终末冲洗方案中使用 NaClO 和 PUI 的最终冲洗对根管牙本质 DMP1-CT 表达、生物化学成分和显微硬度有不利影响。
适当的冲洗方案有利于保持根管牙本质的超微结构,促进充分的黏附,并维持有利于生物矿化和再生的有利条件。